Provider Demographics
NPI:1962565101
Name:LESLIE, NORMA JUNE (RNNP, LMFT,)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:JUNE
Last Name:LESLIE
Suffix:
Gender:F
Credentials:RNNP, LMFT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 E DESERT TRUMPET RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-5917
Mailing Address - Country:US
Mailing Address - Phone:602-540-7670
Mailing Address - Fax:480-820-4001
Practice Address - Street 1:1972 E BASELINE RD # B102
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1532
Practice Address - Country:US
Practice Address - Phone:602-540-7670
Practice Address - Fax:480-820-4001
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN19931363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health